The Expectant Father. Armin A. Brott

Triche and her colleagues found that “women who had five or more servings of chocolate each week in their third trimester were 40 percent less likely to develop preeclampsia than those who ate chocolate less than once a week.” Apparently, there’s a chemical in chocolate, theobromine, that dilates blood vessels and reduces blood pressure. But do you really think your partner needs an excuse to eat more chocolate?

      MISCARRIAGES

      The sad fact—especially for pessimists like me—is that miscarriages happen fairly frequently. Some experts estimate that between a fifth and a third of all pregnancies end in miscarriage (sometimes also called “spontaneous abortion”). In fact, almost every sexually active woman not on birth control will have one at some point in her life. (In most cases the miscarriage occurs before the woman ever knows she’s pregnant—whatever there was of the tiny embryo is swept away with her regular menstrual flow.)

      Before you start to panic, there are a few things to remember: First, over 90 percent of couples who experience a single miscarriage get pregnant and have a healthy baby later. Second, many people believe that miscarriages—most of which happen within the first three months of the pregnancy—are a kind of Darwinian natural selection. Some have even called them “a blessing in disguise.” In the vast majority of cases, the embryo or fetus had some kind of catastrophic defect that would have made it incompatible with life. Still, if you and your partner have a miscarriage, you probably won’t find any of this particularly reassuring. And it won’t make it hurt any less.

      Until very recently, miscarriage, like the pregnancy it ends, had been considered the exclusive emotional domain of women. Truth is, it isn’t. While men don’t have to endure the physical pain or discomfort of a miscarriage, their emotional pain can be just as severe as their partner’s. They still have the same hopes and dreams about their unborn children, and they still feel a profound sense of grief when those hopes and dreams are dashed. And many men, just like their partners, feel tremendous guilt and inadequacy when a pregnancy ends prematurely.

      Some good friends of mine, Philip and Elaine, had a miscarriage several years ago, after about twelve weeks of pregnancy. For both of them, the experience was devastating, and for months after the miscarriage they were besieged by sympathetic friends and relatives, many of whom had found out about the pregnancy only after it had so abruptly ended. They asked how Elaine was feeling, offered to visit her, expressed their sympathy, and often shared their own miscarriage stories. But no one—not even his wife—ever asked Philip what he was feeling, expressed any sympathy for what he was going through, or offered him a shoulder to cry on.

      If You’re Expecting Twins

      If your partner was carrying twins (or more), miscarrying one “does not seem to have negative implications regarding the health or genetic integrity of the surviving fetus,” say doctors Connie Agnew and Alan Klein. Miscarrying a twin may, however, put your partner at a slightly higher risk of going into preterm labor.

      If your partner is carrying three or more fetuses, you may have to deal with the question of “selective reduction.” Basically, the more fetuses in the uterus, the greater the risk of premature birth, low birth weight, and other potential health hazards. Simply—and gruesomely—put, all these risks can be reduced by reducing the number of fetuses. It’s an agonizing decision that only you and your partner can make. Since 1980, the number of twin births has doubled, and the number of unplanned triplets, quads, and so on has more than quadrupled. Fortunately, as ART methods improve, that trend has been slowly declining, which means that fewer and fewer couples will be faced with this heartrending decision.

      Psychologists and sociologists have conducted many studies on how people grieve at the loss of a fetus. But the vast majority of them have dealt only with women’s reactions. The ones that have included fathers’ feelings generally conclude that men and women grieve in different ways. Dr. Kristen Goldbach found that “women are more likely to express their grief openly, while men tend to be much less expressive, frequently coping with their grief in a more stoical manner.” This doesn’t mean that men don’t express their grief at all, or that they feel any less grief than women. Instead, it simply highlights the fact that in our society men, like my friend Philip, have virtually no opportunity to express their feelings—at least not in the “traditional” way. Many men respond to their grief by doing everything they can to get life back to normal. That often means going back to work and putting in extra-long hours. It’s a way of getting away from the self-blame and feeling of helplessness at not knowing how to comfort their partner. It’s a way of avoiding the barrage of baby images that was probably always there but now seems much more pervasive. It’s a way of coping with their grief and, unfortunately, of ignoring it.

      Trying Again

      If you’ve suffered a miscarriage and have decided to try to get pregnant again, your goal is to prepare a healthy environment for the baby to swim around in, and to prevent birth defects or other complications.

      One of the most crucial times of the pregnancy is between 17 and 56 days after conception. That’s when the organs start developing. But because this stage happens so early on, it’s entirely possible that your partner might not know she’s pregnant. And by the time she finds out, she may have already done all sorts of things that could affect the baby—things she’ll wish she hadn’t done.

      For that reason, it’s important to prepare yourselves for the next pregnancy as far in advance as you can. From six to nine months would be great, but even a month or two can make a big difference.

      Preconception

      The rest of this book is devoted to how to have a healthy, safe pregnancy and a healthy mom and baby. But right now, we’re talking about steps you can take before your partner conceives again that can boost your chances of getting pregnant, make for a less eventful pregnancy, and potentially help you reduce or avoid the expense and emotional ups and downs of fertility treatments.

      You never know when your partner is going to burst out of the bathroom waving a little white stick and announce, “Honey, I’m pregnant!” So before the two of you hop in the sack, there are a few things that she should do, you should do, and the two of you should do together to get ready.

      Pregnancy after a Miscarriage

      Getting pregnant after having lost a baby can bring up a jumble of feelings for both you and your partner. For example, you’ll probably be feeling incredibly happy that you’re expecting again. But you may also be worried that this pregnancy will end the same way the last one did. That could keep you from allowing yourself to become truly engaged in and enjoy the pregnancy—at least until after you’re past the point when the miscarriage happened last time. If your partner is feeling this, she may deliberately keep herself from bonding with the baby, trying to save herself the grief if the worst happens again. If it’s been a while since the miscarriage, you might be angry—in an abstract sort of way—that you’re still expecting, when by all rights you should be holding a baby in your arms right now. But if your partner got pregnant right away, you might be feeling guilty at not having let an appropriate (whatever that means) amount of time pass.

      Everyone deals with post-miscarriage pregnancy differently, but there are a few things that may make it a little easier:

      • Try not to worry. It may have happened before, but chances are it won’t happen again. Only 1 in about 200 women are what are called “recurrent miscarriers,” meaning that they have had three miscarriages and have never delivered a child.

      • Don’t pay attention to other people’s horror stories (you’d be amazed at how insensitive some people can be).

      • Don’t tell anyone about the pregnancy until you’re absolutely ready to, and then tell only people you’d want to support you if something bad were to happen (see pages 82–83 for more on this).

      • Get some more ultrasounds or listen to the heartbeat—this might help to reassure you that all is well.

      • Get some support. If your partner can